MEDICARE: DR. JEFFREY SCOTT KEYSAR D.C.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor	B01584	NV

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	U76702	OTHER	NV	UPIN

General Provider Information

NPI Number	:	1558311100
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JEFFREY SCOTT KEYSAR D.C.

Provider Business Mailing Address
First Line	:	1437 HARMONY HILL DR
Second Line	:
City	:	HENDERSON
State	:	NV
Zip	:	89014-2518
Country	:	US
Telephone Number	:	702-325-1072
Fax Number	:

Provider Business Practice Location Address
First Line	:	5836 S PECOS RD # D-101
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89120-3418
Country	:	US
Telephone Number	:	702-325-1072
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/12/2006
Last Update Date	:	09/30/2015

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